Teens with Alternative Self-Identity More Likely to Self-Harm

A new European study revealed that around half (45.5 percent) of teens in alternative subcultures self-injure and nearly 1 in 5 (17.2 percent) attempt suicide.

Researchers from the Medical Research Council (MRC) at the University of Glasgow and from the University of Ulm, Germany, designed the study to look at why these teens are more likely to self-harm and how their motivations differ from other teenagers.

Overwhelmingly, the reasons teenagers in this study gave to explain why they self-injure was to regulate distressing emotions and communicate this distress to friends and family.

Although prior research suggested that a majority of adolescents who self-injure have friends who also self-injure, the new study did not find substantial evidence that self-injury might be socially contagious.

That is, only a few teenagers were found to self-injure because they wanted to feel more part of a group.

Researchers report their findings in the journal BMC Psychiatry.

Investigators studied 452 German students, aged 14-15 years. Pupils were asked to answer questions on how strongly they identified with different youth cultures, such as Alternative (Goth, Emo, Punk), Nerd (academic) or Jock (athletic).

They were also asked about risk factors strongly linked to self-injury including demographic (gender, immigration), social background (parent’s social and economic status) and victimization (physical bullying and verbal harassment).

Researchers found teenagers with an Alternative identity were 3-4 times more likely to self-injure and 6-7 times more likely to attempt suicide than other teenagers, even after allowing for known risk factors.

Identifying as an “Alternative teenager” was a stronger predictor of self-injury or a suicide attempt than being repeatedly bullied.

The scientists investigated if adolescents from different social groups are at greater risk of self-injury.

Athletic teens (Jocks) are less likely to self-injure than others. The authors speculate this may be attributable to the effect of regular physical exercise which has been shown to improve mood and combat depression in adults.

Interestingly, the findings indicate that academic (Nerd) teens do not experience the peer exclusion and victimization stereo-typically associated with such pupils. In fact, modern ‘nerds’ seemed no more likely to self-injure or be suicidal than the other teenagers.

The authors recognize the study has several limitations.

For example, information was self-reported and only a minority (7.4 percent, n=33) of pupils identified as Alternative youth. The study does not prove that identifying with alternative culture causes teens to self-harm.

Rather it is equally likely that isolated teenagers struggling with emotional difficulties are naturally drawn to a musical (sub)culture that expresses these feelings and membership may even have positive social or cathartic effects.

In previous research, Robert Young, senior investigative scientist at the MRC Social and Public Health Sciences Unit and lead author of this study, found a strong association between self-injury and the Goth youth culture among Glasgow teenagers.

Over half (53.5 percent) of Glaswegian Goth teens reported they had engaged in non-suicidal self-injury and 47 percent claimed to have attempted suicide.

Accordingly, the new study suggests the “Alternative identity effect” has not diminished and is found among the current generation of teenagers.

Said Young, “Our work highlights just how strongly adolescents’ social identity is linked with their self-harming behaviors.

“We hope the findings can be used to both identify young people at risk and help them to manage their emotions in less destructive ways that are tailored to their natures.”

Researchers believe a next step is to determine if this phenomenon is exclusive to western society or if alternative youth around the world experience the same effect.

Co-author Paul Plener, M.D., an Ulm University child and adolescent psychiatrist who specializes in music therapy for self-harming adolescents, comments: “Our research supports the notion that social mechanisms influence self-harm.

“This is a crucial finding when thinking of ways to address and prevent self-harm in adolescence.”

Plener believes that new therapeutic approaches can build on the strong identification with a certain kind of music or youth group. Therefore, music therapy in combination with strategies to decrease distress are a feasible option for addressing self-harm.

Dr. David Lomas, chair of the MRC Population and Systems Medicine Board, commented on the study.

“Global estimates suggest 30 percent of all teenagers have suicidal thoughts, 18 percent have self-injured and 4 percent actually attempt suicide and the overall rates in this study were typical for this age group — 26 percent, 21 percent and 4 percent respectively,” he said.

“Understanding the reason why different groups of teenagers self-injure will hopefully lead to early detection and help develop effective interventions for those at risk from self-injury or suicide.”

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Rick Nauert PhD

Dr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.